Working women, maternity entitlements, and breastfeeding: a report from Bangladesh

Abstract

Early infant feeding practices and facilities available for supporting breastfeeding in workplaces in Dhaka, Bangladesh were studied through interviews with working women (n = 238) with children younger than 30 months of age. Of the women interviewed, 20 percent were aware of the benefits of, and had exclusively breastfed in the first month, 13 percent in the second month, and two percent in the fifth month of employment. The median age of starting complementary feeds was 41 days (range, 1-210) preparatory to resuming work. Total duration of breastfeeding was significantly shorter in mothers who had started these feeds before 41 days of age as compared to those who started later (mean +/- SD) 275 +/- 216 days versus 361 +/- 223 days (p = 0.003). Ninety-nine percent of the mothers were unaware of their maternity entitlements, and only 20 percent had taken breaks for breastfeeding, those breaks being treated as "unofficial." Working women should be informed through health personnel and communication media, about the benefits of exclusive breastfeeding and about maternity entitlements. Provision of facilities to support breastfeeding in the workplace must also be encouraged so that maternal employment does not hamper breastfeeding.

PIP: Interviews were conducted among 238 working women with children younger than 30 months of age who worked in Dhaka, Bangladesh. The study aims were to establish baseline estimates of breast feeding and infant feeding practices among working women, to assess the extent to which women were aware of maternity benefits, and to obtain women's suggestions on how to improve facilities for supporting breast feeding. Women were interviewed at their places of work. Breast feeding was identified as exclusive, predominant, or complementary. Women averaged 29 years of age (median) and had an average of 12 years of education (median). Their monthly salaries averaged $79. Mothers resumed work 76 days after the birth (range, 7-270 days). 72% were breast feeding at the time of the interviews. 99% initiated breast feeding with colostrum within a median of 10 hours after the birth (range, 1-96 hours). 10% (48 mothers) exclusively breast fed during the first month and 13% did so during the second month. Only 2% (5 mothers) exclusively breast fed for the first 5 months. 83% (199 mothers) predominantly breast fed (breast milk plus water) in the first 3 months. By 41 days after the birth, many added other foods. 46% introduced foods in order to return to work and 23% did so at the doctor's suggestion. 11% (26 mothers) left expressed breast milk at home at room temperature for daytime feedings. Only 9 mothers expressed milk at work. The median duration of breast feeding was 300 days (range, 0-820 days). Early introduction of foods was related to shorter duration of breast feeding. 99% of mothers were unaware of national or international laws on breast feeding. 95% of mothers would bring infants to work if facilities permitted. 60% thought their employers could provide facilities.